Abstract:

Background: Hepatitis B, an important public health problem, globally affects 296 million people in 2019. Annually, an estimated 820,000 people die from its liver complications. It is endemic in much of the developing world, where 8 – 10% of the population are infected. It has caused epidemics in parts of Asia and Africa. In Africa, 75 million people are affected by the virus, ranging from 13.6% in Nigeria to 5.7% in Ethiopia. The public health burden of HBV infection in Tanzania is unknown, despite its longstanding reputation as to be among the highly endemic countries of sub-Saharan Africa. Medical students are a group at high risk of getting and spreading HBV because their activities involve contact with patients, blood and other body fluids. No such study had been conducted at CUHAS thus the study set out to assess the uptake, financial constraints and Hepatitis B knowledge as determinants of hepatitis B vaccine uptake among medical students in the institution.

Methodology: The study design was cross sectional descriptive study that rely on quantitative methods of data collection using a standardized structured questionnaire. The interview questions were developed in English and included questions related to social demographic characteristics, knowledge, attitude and practice towards Hepatitis B vaccination. Data coded and entered into Microsoft excel 2016 spreadsheets and analyzed using SPSS software version 17.0 . Descriptive statistics used to express means and nominal as percentages.

Results: A total of 286 medical students took part where it was found that the uptake was at 41.26% of which only 12 (10.17%) had received the full 3 doses recommended and the remaining 106 (89.83%) had not completed. 132 (78.57%) of those had never received the Hepatitis B vaccine cited financial constraints as a hindrance to them receiving the expensive vaccine while 36 (21.43%) cited religious or cultural prohibitions. All 286 (100%) of the CUHAS medical students were knowledgeable on the existence of a vaccine against HBV and were fully aware of the School’s/Hospital’s arrangement of periodically availing, at a cost, vaccination services within the hospital’s premises. Therefore knowledge did not play a positive role towards uptake and financial constraints were found to be the major hindrance to vaccine uptake. It was concluded that, vaccine uptake was low and required intervention, knowledge did not improve vaccine uptake while financial implications hindered uptake.

Conclusion: Uptake of Hepatitis B vaccine among CUHAS medical students was low at 41.26% and this demand urgent remedial interventions. Ample knowledge concerning Hepatitis B vaccine, number of doses required and availability of vaccination services did not have the expected positive impact on vaccine uptake or dose completion and thus did not play any positive role in Hepatitis B vaccine uptake. Financial factors arising from the cost implications of acquiring the required 3 full doses of the Hepatitis B vaccine and the financially constrained status of the students, hindered Hep-B vaccine uptake.